Nine Digestive Disease Myths

Medical Reviewers and Editors: Jay W. Marks, MD, and Melissa Conrad Stöppler, MD

Researchers have only recently begun to understand the many, often complex, diseases that affect the digestive system. Accordingly, people are gradually replacing folklore, old wives' tales, and rumors about the causes and treatments of digestive diseases with accurate, up-to-date information. But misunderstandings still exist, and, while some folklore is harmless, some can be dangerous if it keeps a person from correctly preventing or treating an illness. Listed below are some common misconceptions (fallacies), about digestive diseases, followed by the facts as professionals understand them today.

Myth # 1 Ulcers: Spicy food and stress cause stomach ulcers.

False

The truth is, the majority of stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen, the so-called nonsteroidal antiinflammatory drugs (NSAIDs). Most H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Now that it is appreciated that H. pylori and NSAIDs are the cause of most ulcers and patients are being managed appropriately, the ulcers that are coming to medical attention are increasingly likely to be unrelated to H. pylori or NSAIDs. Spicy food and stress (except when associated with extreme medical conditions) may aggravate ulcer symptoms in some people, but they do not cause ulcers.

Ulcers can also be caused by cancer.

Myth # 2 Heartburn: Smoking a cigarette helps relieve heartburn.

False

Actually, cigarette smoking may contribute to heartburn. Heartburn occurs when the lower esophageal sphincter (LES) - a muscle between the esophagus and stomach - relaxes, allowing the acidic contents of the stomach to splash back (reflux) into the esophagus. People who smoke more frequently have inflammation of the esophagus (esophagitis), presumably caused by increased reflux of acid, that is the basis of heartburn. The increased reflux is believed to be due to the fact that cigarette smoking causes the LES to relax.

Myth # 3 Celiac Disease: Celiac disease is a rare childhood disease.

False

Celiac disease affects both children and adults. About 1 in 200 people in the United States have the genetic predisposition for celiac disease although not all of them have the disease. Sometimes celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults of any age. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating and abdominal distention, flatulence, diarrhea, and abdominal pain due to the involvement of the small intestine as well as skin rash, anemia, and thinning of the bones (osteoporosis) due to malabsorption of nutrients by the diseased intestine. Celiac disease may cause such nonspecific symptoms for several years before being correctly diagnosed and treated.

People with celiac disease should not eat any foods containing gluten, a protein in wheat, rye, and barley, whether they have symptoms or not. In celiac disease, gluten provokes an inflammatory reaction by the body that destroys the lining of the small intestine, which interferes with the absorption of nutrients. Even a small amount of gluten can cause damage, and sometimes no symptoms will be apparent.

Myth # 4 Bowel Regularity: Bowel regularity means a bowel movement every day.

False

The frequency of bowel movements among normal, healthy people varies from three a day to three a week, and some perfectly healthy people fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. People with irritable bowel syndrome (IBS) may have fluctuating numbers of stools each day as well as fluctuating consistency of their stools.



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